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Tuesday, 20 March 2018

Boob feeding

I write this post as my now 12 week old feeds from my boob. I have been thinking about writing this for a while but I've not really been sure where to start. There's so much to say about being a new mum and what it's like to have a newborn. I think the most difficult thing to wrap my head around is that there's no definite right or wrong answer for most things.

Once Pippa woke up and started feeding a few days in, breastfeeding has been easy for me. I am very grateful for this as I've worked with so many mum's and babies who find it very difficult, if not impossible. However, I have quickly learnt that there is so much more to it than simply positioning and attaching a baby. Or is it that simple? It kind of is really but the need to explain/complicate everything is overwhelming...

Not one feed is the same therefore how long should a feed be? What counts as a full feed and should I offer the same side again or the other side? Foremilk and hindmilk? I thought these terms were old hat now but when my girl was having unexplained green poos in the afternoon with no other clinical symptoms of her being poorly, Dr. Google informs me that it must be a foremilk/hindmilk imbalance. Now should I worry about that? I've now learnt no, I shouldn't, but only after a few weeks of trying many different things to 'right' her 'wrong' poo. Most websites recommend block feeding to ensure baby completely drains one boob before going onto the next. Not only does this give you very lopsided boobies but it also can reduce your milk supply. Unless you genuinely have too much milk (which your baby negates so it's unlikely) then messing with milk production seems a silly thing to do. So how do I stop the green poops? I was obsessed until I gave up trying to 'fix' it and forgot about it instead... Guess what, that in itself worked! She only has the occasional green poo now.

Lots of forum reading as told me that it's relatively common for breastfed babies to have yellow stools all morning then greener ones in the afternoon/evening. Quite often I wake up like Dolly Parton in the morning and baby will only take short feeds, probably due to having lots of milk so not having to work as hard to get it. A quick boob squeeze instantly shows me that this milk is much more watery than the stuff in the evening which is much creamier and fattier looking. She also tends to feed longer in the evenings because she has to work harder to get the milk out. Anyway, back to the forum post; this woman was saying that she had spoken to her health visitor about the green poos and she was reassured that the reason the poos are yellow in the morning is because the body takes all night digesting the fattier milk. Then baby takes the watery milk all morning which passes through her digestive system much quicker. This is what makes her poos green. As long as she's showing no other signs of being ill, then there isn't a problem!

DISCLAIMER: I've not looked at any actual research to support this, which if a was a good midwife, I would, but in my mummy state (which is all I'm good for at the minute), this makes sense. My health visitor seened to agree too!

By about 5 weeks, I pretty much felt I had grasped boob feeding and from 6 weeks I started expressing a bit. To begin with I was convinced I couldn't have any milk in there and I must be starving my baby because I couldn't get any milk out. Well, only when I had my Dolly Parton boobs in the morning anyway. After yet another frantic Google, I then tried expressing one side whilst feeding the other side... Bingo!!! Plenty in there after all. I just needed her to initiate the let down reflex to get it out. I only have a hand pump though so it took a bit of practice and a few spillages to master holding a baby and pumping at the same time! Before I knew it I had 1.6L in the freezer ready to feed my bubba when I wasn't with her.

The aim of all this was because we/I had/have a few things coming up where we didn't intend on Pippa going to. The main one being the Harry Potter stage show in London, a two performance show which would have meant us being away from her all day and evening. In hindsight, we should have tried to introduce a bottle sooner but I kind of let that slip as I just assumed that after a few goes, she'd feed fine, specially as she had a teat very early on in her life... Turns out she completely forgot how to use one and had no incentive to re-learn! Why on earth would she want a weird plastic thing in her mouth when she could have milk from its source and have a lovely comforting mummy cuddle at the same time?! After spending a lot of money on a variety of tests and bottles and a few stressful days trying to get her to feed, we gave up. I started to hate the idea of her having a bottle as much as she hated it being shoved in her gob. I feel so grateful that breastfeeding has been straightforward, I didn't want to ruin it just for the odd day here and there. In the big scheme of her life, this period is so short, missing out on a few things really isn't a big deal. We got out money back on the Harry Potter tickets and the other things I'll just have to make work. She came on a hen do with me last weekend (I was only going to the day), I have another in a couple months and then the weddings too. Ideally they don't want kids at the weddings but they're both really good friends of mine so hopefully we can work something out! Other than that I don't have to leave her. Now what do I do with all the milk in the freezer?!

It's one thing getting to grips with breastfeeding at home, but it's a whole other ball game doing it in public! With my relatively small boobs (which aren't so small anymore, I'll show you in a bit, keep reading!), I wasn't too worried about having too much on show but it's still the logistics of actually attaching a baby. The boob needs to come out however discreet you try and make it! I have found using shawls and cover ups a waste of time. Once she's on theres nothing to see anyway and the shawl is in the way when trying to attach her! I need to see my boob to make sure I'm not inadvertently attaching her to my belly button or something (you know what I mean...)! As she's got bigger and has more neck strength,  and she's pretty easy to get in place so I don't tend to worry about having my boob out as it's not for long. Even when shes not attached yet, her head covers most things so old John Doe would have to be staring pretty hard to catch a glimpse of any nipple. Although it shouldn't, I think breastfeeding still makes plenty of people feel uncomfortable so in my experience, as soon as people have worked out what your doing, they make an awkward effort to look in completely the opposite direction anyway! Problem solved! I am yet to be challenged about feeding, but to be honest, I think this is mainly because people just think I am cuddling my precious bubba. I tell you what though, I praise H&M for selling nursing tops which look just like normal tops! No complicated wraps or ugly V-shapes.. I have 5 now and love them... Though, do be careful with that nipple cream... I couple of mine to have grease stains from misplaced Lansinoh cream which doesn't come out!

In between the crazyness of having a newborn baby, I have managed here and there to do some knitting. Thank God my hands are pretty much back to normal! It was in trying on and photographing my latest knit that it was pointed out to me how big my boobs have got!! Look at this for comparison...!!!

Before breastfeeding

Whilst breastfeeding!
I would be really pleased but all I can think is how saggy they'll probably be when I stop feeding! Oh well, enjoy them while it lasts I guess!

My Telja fair isle jumper is the first project I have finished. This is made from wool my mum got me for Christmas and is absolutely lovely!! However, I didn't think about boob access when I chose the pattern. I don't mind though, it'll have to be kept safe until I can wear it! However, with this is mind, I chose a cardigan for my next project. A nice comfy relaxed one with the boob only a few buttons away! I am using a chunky wool which I got sent by mistake so it feels like a freebie knit also! It's a relatively cheap acrylic yarn but never the less, it'll do the job nicely!

If nothing else, in the last 3 months I have learnt not about breastfeeding but about my baby. I actually think breastfeeding is as simple as positioning and attaching a baby on the boob, the rest of it us as human beings make complicated. The rest of the animal world don't rely on the internet to solve their insecurities so  I am going to stop rely on Dr. Google and listen to my gut feeling a little bit more!

Friday, 16 February 2018

The toughest week of our lives: part two

Like writing part one, it has taken me rather a while to get around to this post! Almost another month to be precise. That probably means I am not telling the story in its true form now; as they say, you quickly forget all the finite details... but here goes...

We went home the day after Pippa was born and after my cesarean (day 1). In hindsight this was far too early but I was a midwife and knew what I was doing so felt that I could be at home... I'd be doing the same things at home as I could in hospital right? After the cesarean she was very very mucoussy. Most section babies get mucoussy but she was possibly the worst baby I have ever seen. Because of this she wasn't really feeding very well and whenever she did feed she then vomited back up. Therefore I was trying her at the breast every 3hrs and then expressing and giving her that by syringe. The last good(ish) feed she had on the day we went home was about 7am. usually the wards wouldn't discharge someone when the feeding isn't great but like I said, I'm a midwife and knew the score/what to do etc. Also because I expressed so much antenatally I knew I had plenty of milf for her in the freezer, therefore when I was at home she was actually getting more milk than I was expressing for her in the hospital.

We were discharged at round 2pm and made our way to Jayne's house to pick up the dog on the way home. I was quite adamant that I wanted to introduce the both of them together at home. I didn't want to get Charlie back and the house already smell of this new weird creature. Again, with hindsight, this was our second mistake.

Initially is was nice being home and in my own environment but I soon got stressed about the feeding. It got to about 10pm and she still hadn't been to the breast since that morning and was still being really sick. In the end I rang the postnatal ward and spoke to a lovely, really experienced midwife who advised me to give her a 10ml top up with the intention to make her vomit the mucous out so then hopefully she would want to feed properly; so thats what I did.

1am came and so did the vomit. Loads of it. Darkly blood stained and it absolutely stank! Not normal what so ever!!!! I rang 111 who advised me that we should get her seen at the childrens hospital within an hour. Shit. Scott hadn't slept for god knows how long so was worried about him driving. I had managed to catch an hour just before the vomit happened but there was no way I could have driven.

Well this dilemma was taken out of our hands. I went to let the dog out for a wee before we left and Scott was changing Pippa's nappy when I hear this panicked call from upstairs. Rushing up, I find a very blue, not breathing baby on the changing table with loads more bloody vomit obstructing her nose and mouth. I instantly went into work mode and resuscitated her. At the time it felt like forever but it was probably no longer than a minute or so and she came round well. However because of this there was no way in hell I was putting her in the car and driving ourselves. I was NOT going to resus her again at the side of the road if it happened again. I rang 999 who agreed and sent us an ambulance.

On arrival of the ambulance crew she did her third bloodstained smelly vomit. They hadn't had any experience of such a young baby so I think they were thankful that I was a midwife. All we needed was the ride (and possibly to resus equipment if she went blue again). and they were happy for me to take the lead: fortunately it wasn't needed. When they saw the vomit though they did call ahead to the childrens as they were concerned about it too and they advised us to be blue lighted in. Luckily it was 2 in the morning by then so the roads were clear. I sat on the stretcher strapped in and held Pippa so she was upright. This worked well for me too as I was somewhat cushioned from the very bumpy journey, though to be fair at this point the last thing I was thinking about was myself.

When we got to the Childrens they did a full check on her which was fine and they weighed her too. This was a day earlier than it would usually be done (day 2 rather than day 3) and showed that she has lost 14% of her birth weight!!! Ouch! On day three we would expect babies to loose upto 10% of their birth weight so 14% really isn't good. Yet again, in hindsight it's not surprising as she vomited up more than she was getting in but at the time I felt like I had failed her. Luckily her blood tests showed that she wasn't too badly affected by the weight loss but did show that she had an infection. Because the blood she had vomited was old looking and not bright and fresh, it was believed that it was from me rather than her. They tested my breast milk but I knew it wasn't that as the blood in the vomit was way too much to be from me; specially when I was expressing and my milk was not obviously blood stained. Later on it was assumed that she probably ingested it at the cesarean and it festered in her which caused her infections. This explains why is was so heavily blood stained and why it smelt so bad.

After about 10hrs of observation, they wanted to admit her to the childrens hospital which would have meant I was staying as an outpatient... By this point it was lunchtime, I hadn't slept and had had minimal pain relief. I really needed to be an inpatient too. Unfortunately, once a baby is discharged post birth it is usual protocol to go to the childrens rather than back to the maternity unit which is hence why we ended up there. Because of this you usually then wouldn't get transferred back but I begged and luckily (probably because I am staff), Southmead did have us back.

As we were taken to the childrens by ambulance, our next issue was how to get from the centre of Bristol to Southmead. Luckily we have great friends who were so helpful. Jayne works in the centre so has a permit to park in all the streets. They drove both of their cars in, parked hers in a side street nearby and dropped the keys into Scott so we had transport. Luckily we had thought about the car seat when we left home the night before so had it with us.

We got back to Southmead at about 4pm by which point I felt like utter death, I cried all the way up the corridor to the ward, I was just so thankful to be back. Once we settled in they got the neonatal doctors there to review her, restested her bloods (including a septic screen) and reweighed her. They actually made her weight loss 12.7% so slightly better than at the childrens - probably the difference in scales and she had also had several formula feeds by this point which may also have helped. She started IV antibiotics and a feeding regime to get her back on track. This meant I was trying her at the breast every 3 hours, topping her up with as much formula as we could get in her and I was expressing and giving that too. I was so so thankful that one, I had a single room and two, that Scott could stay with me, I never would have managed it all on my own! I was pretty sleep deprived and emotional too so I don't think I would have coped with him having to leave me. He did pop home to meet Jayne to give her car back and to hand the dog back over to her. Poor Charlie had been on his own all day bar the neighbours popping in a couple times to let him out for a wee. If he hasn't freaked out enough by this new human in his house, he then suffered the stress we did in the middle of the night and then got left all on his own! I felt so awful for him! Luckily he loves staying with Jayne and her dogs so at least I knew he was happy there.

In the first 24 hours of being back in hospital (day 3) her weight went to 10.8%, a fantastic gain. It should have been though as she was absolutely pumped full of formula. So much so that its was impossible to get her to feed from me as she was so full all of the time. Therefore the next task was to get her to feed from me. As absolute luck would have it she got the message and literally woke up and decided to feed from me without much effort. She literally jumped on the boob. She still needed to feed 3 hourly but the plan was not to give her anymore formula providing she did feed. In the next 24hrs (day 4) her weight stayed the same. Although that doesn't sound good, they were happy with that as she had gone from having loads extra to just relying on me. However, in the next 24hrs (day 5) she had to gain else we would have to give her formula again. I hated giving her formula, she was sicky before but she was so so so much worse on the formula. It stinks too which meant she stank all the time. She spat it out a lot and got a rash on her chin. Luckily enough in she gained 30g taking the percentage to 10% exactly. This is considered a fine gain in such a short space of time. Each day she was also having her CRP checked and the same day it came back showing that the infection had resolved enough for her to stop the IV antibiotics.. this meant we could go home again!! These days had been the most stressful of our lives so leaving the hospital where I had 24/7 support was rather scary, specially after what happened the last time we went home. It felt like such a huge responsibility feeding her myself and the stakes were high because she had been so poorly. But we had to leave sometime right? So we did, and it was fine.

Although I knew full well about the baby blues, I never anticipated how bad they could be! Even when we were doing well at home I found myself randomly bursting into tears over absolute nothing. It went on longer than I thought too but then I guess it's such a huge adjustment both physically and mentally and I was being hard on myself. We didn't exactly have an easy start either!! But onwards and upwards, things did get better...

In the next installment I wish to natter on about how complicated the human overthinking brain can make breastfeeding and the wonders of the first few weeks as new parents! Now how long it will take me to get around to writing it, who knows!!

Saturday, 20 January 2018

The toughest week of our lives: part one

It's taken long time for me to have a chance to write these posts and it appears having a newborn means you have absolutely no time to yourself.

After my last post about reaching my due date, I ended up going more than a week overdue. We never wanted to commit to Christmas plans as we didn't know when this baby would arrive. I was convinced that if she didn't come early, then she would want to come on Christmas day. Well Christmas eve (5 days overdue) came and she was showing absolutely no signs of coming so we decided to go back to Devon for Christmas. This felt a little risky really but we packed all the hospital stuff just in case; at the end of the day it's still only just over an hour away if we needed to get back.

We were only home from Christmas eve morning until boxing day morning but the whole time I felt really very rotten. So much so that we came back early boxing day so I could see my midwife to get checked out. I wasn't really sleeping and getting myself pretty stressed, mainly worrying about my blood pressure. It's been on the higher side for a while and when at home I used Richards BP monitor to check it just out of interest. I don't think it was very accurate really as one reading was pretty high, the other completely normal, but this didn't do much good for my stress levels! Anyway, when back and at the midwife's, she confirmed that my blood pressure was high and sent me into hospital to get checked out.

Apologies for how awful I look! I was soo swollen!

When we got there it remained high but I didn't have any other symptoms of pre-eclampsia so they didn't medicate me but offered me induction. After a pretty long discussion with Scott we decided that induction was probably for the best. I had felt rubbish for ages and the blood pressure was most likely due to my stress so what was the point prolonging it any more? I had been niggling for ages and ages but labour was nowhere near.

So I had the propess and off to the ward I went to wait for things to happen. Scott went home to get some rest and sort the dog out and I got some kip. The propess was a pain in the arse, I was having so much mucoussy show that every time I got up, it came out!! This meant I ended up with loads of examinations before I was even doing anything.

By the morning I was tightening pretty regularly and when Scott came back in at 10am I was uncomfortable enough to need my TENS machine. At points I think it really helped but it was also annoying too, more of a distraction that actual pain relief but still, at least it seemed to be doing something. The last time the propess came out (about 8am) they said that they'd be able to break my waters so I went on the waiting list to go to delivery suite.

By about 2pm, I was contracting 4:10 lasting over 1min. GREAT! Getting there, hopefully...

At 3pm I was transferred to delivery suite and they broke my waters. Despite contracting already, there had been no change in my cervix. Up until this point although the contractions were painful, I was fully coping with them and felt in control of what was happening. As soon as my waters went I felt like I was dying. I cannot explain how horrendous it was. I felt like my whole pelvis was being ripped apart, the contractions were back to back and I was having no break to recover in between. I was only 1cm dilated so to begin with I refused to use the entonox... It was my first baby and I was only 1cm, I had a LONG LONG way to go and my experience as a midwife told me not to use it.... That last probably about 4 contractions and then I was puffing on it like my life depended on it. Unfortunately for me, it did absolutely nothing for the pain but just made me feel like I was VERY drunk and VERY out of control. I was screaming the place down which was particularly awful as I was in the room next to the staff room so all of my colleagues would have heard me making an absolute meal of it. I'm soo embarrassed. I knew I would swear, and I swore A LOT! After just a few minutes on the entonox I was begging for some pethidine which they gave me straight away, This seemed to space the contractions out a bit and relaxed me in between but when they did come they were still excruciating. So much so that I was begging for my epidural straight away, which again I got pretty much in record time, they didn't waste any time. Probably desperate to shut me up. The anesthetist (who I didn't know) was great but she did take two attempts at getting my epidural in and then I had quite a high block. I didn't care, it bloody worked and I was finally out of pain!

Not the way I intended on labouring..
Soon after my epidural went in they reexamined me. I can't remember the timings exactly but it couldn't have been much longer than about an hour from them breaking my waters; I had gone from 1cm to 4cm. Not bad!! Maybe thats why is was so excruciating?

3 hours later I was 4cm again, and they ascertained that baby was deflexed OP position (back to back with her head at the wrong angle) and I started the synto drip to make my contractions more effective. I was also pretty sore down below which my midwife put down to maybe a latex allergy from the catheter? I was really swollen and sore looking. I hadn't realised I was sensitive to latex before, you would have though I'd known as I use latex all the time when working. My hands often get dry and sore after working but I always put that down to washing them regularly at work, not because of the latex gloves.

Anyway, 3 hours after starting the drip, I had only progressed to 5cm. I was feeling pretty downhearted. Again being a midwife, seeing that little progress and having a baby in the position that mine was, I knew the outcome was looking pretty bleak. I was lucky enough to choose the midwife looking after me and we had a good talk about what it all meant. I was ready to give up and request a cesarean. She said to me that I had only been on the synto for 3 hours and that I should give it more of a chance. She said that if I was her daughter, her advice would be to carry on for another 3 hours to give myself as much chance as possible. So that's what we did.

3 more hours passed, and I was 5-6cm... So decision made, we went for a cesarean section. This was fine by me, I understood and wasn't really scared of theatre. Id been on the other side a million times so knew exactly what to expect. The only thing I was nervous about was knife to skin. As soon as that was done and I didn't feel it, I was fine. Scott, however, didn't like theatre at all. Not surprising I guess as he's never been in a situation like that in his life; and a very different experience than just me, him and the midwife in a room on our own.

Philippa Mary Ware
28th December 2017 @ 03:37am
7lb 13oz

Done. In no way the way we would have liked but I can't exactly say I'm surprised. I always had a feeling that things wouldn't be straightforward. But I don't mind, we have our beautiful baby girl. It's all worth it. Labour was horrendous and I can't imagine ever wishing to do it again but I am so thankful for the amazing care we received, we couldn't have asked for anything more. 

I'd like to say that all was well from now on but that wasn't the case, stay tuned for part two of our saga!

Tuesday, 19 December 2017

Due Date

So today's the day, the due date! I really thought I would have had a baby by now. I was soo convinced I could get her out early. Just goes to show doesn't it! I write this post right before going to bed with just an hour left of the 19th so its a pretty dead cert that shes not showing her face today! Grrr!!

Today, I went for a long walk around westonbirt with some work friends to see if that might encourage her... I have had a few tightenings but nothing exciting, only the same tightenings I've been getting for weeks. I think shes far too comfortable in there!

The texts and messages from everyone have already started "any news? Any signs? Had a baby yet??" That's going to get annoying very quick! Didn't think anyone really cared that much!

I really would like a baby before Christmas so that gives her another 5 days. Either that or wait until after boxing day, for babies sake More than anything. The lead up to Christmas is always exciting and fun, particularly when in school. However having a Christmas birthday is a bit rubbish as it's often over looked and I also think that the time between Christmas and new year is a bit depressing too!

I'm going end up being induced on New years eve (term +12) aren't I!!!

Wish me luck!